Total Hip Arthroplasty in a Patient with Paget’s Disease. Case Report
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Published:
Oct 24, 2022
Keywords:
Paget´s disease, total hip arthroplasty, bisphosphonates, hip, surgery, dislocation
Main Article Content
Abstract
Introduction: Paget’s disease is a metabolic disorder of unknown etiology, secondary to an increase in the function of osteoclasts and the consequent response of osteoblasts to excessive bone formation. It most commonly involves the proximal femur and is often diagnosed incidentally. We present the case of a woman with a history of Paget’s disease and nonunion of the left hip, with indications for a total left hip prosthesis and a single episode of dislocation, without subsequent complications and an adequate evolution.
Conclusion: Surgical management in cases of hip fracture allows to restore walking and improves the quality of life of patients with Paget’s disease. Despite being a pathology that makes patient management difficult, Paget’s disease is not a contraindication for total hip arthroplasty and allows the improvement of pain and restoration of functionality.
Conclusion: Surgical management in cases of hip fracture allows to restore walking and improves the quality of life of patients with Paget’s disease. Despite being a pathology that makes patient management difficult, Paget’s disease is not a contraindication for total hip arthroplasty and allows the improvement of pain and restoration of functionality.
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How to Cite
Restrepo-Noriega, V. E., Serna Maya, I. D., Guzmán-Benedek, D. L., & Corrales-González, M. (2022). Total Hip Arthroplasty in a Patient with Paget’s Disease. Case Report. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 87(5), 693-702. https://doi.org/10.15417/issn.1852-7434.2022.87.5.1386
Section
Case Presentations
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References
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https://doi.org/10.1016/j.amjmed.2018.04.028
2. Crego-Vita D, Aedo-Martin D, Sánchez-Pérez C. Case report of early aseptic loosening of total hip arthroplasty
inmonostotic paget disease, a diagnostic challenge. Int J Surg Case Rep 2016;24:215-8.
https://doi.org/10.1016/j.ijscr.2016.05.050
3. Siris E, Ottman R, Flaster E, Kelsey JL. Familial aggregation of Paget’s disease of bone. J Bone Miner Res
1991;6(5):495-500. https://doi.org/10.1016/j.ijscr.2016.05.050
4. Ralston SH, Layfield R. Pathogenesis of Paget’s disease of bone. Calcif Tissue Int 2012;91(2):97-113.
https://doi.org/10.1007/s00223-012-9599-0
5. Reddy SV. Etiology of Paget’s disease and osteoclast abnormalities. J Cell Biochem 2004;93(4):688-96.
https://doi.org/10.1002/jcb.20256
6. Vallet M, Ralston SH. Biology and treatment of Paget’s disease of bone. J Cell Biochem 2016;117(2):289-99.
https://doi.org/10.1002/jcb.25291
7. Schneider D, Hofmann MT, Peterson JA. Diagnosis and treatment of Paget’s disease of bone. Am Fam Physician 2002;65(10):2069-72. PMID: 12046775.
8. Wegrzyn J, Pibarot V, Chapurlat R, Carret JP, Béjui-Hugues J, Guyen O. Cementless total hip arthroplasty in Paget’s disease of bone: a retrospective review. Int Orthop 2010;34(8):1103-9. https://doi.org/10.1007/s00264-009-0853-7
9. Siris E, Roodman GD. Paget’s disease of bone. En: Rosen CJ, Compston JE, Lian JB (eds). ASBMR Primer on
the metabolic bone diseases and disorders of mineral metabolism 7th ed. American Society for Bone and Mineral Research, New Jersey: Wiley; 2008: 335-43.
10. Kang H, Park YC, Yang KH. Paget’s disease: skeletal manifestations and effect of bisphosphonates. J Bone Metab. 2017;24(2):97-103. https://doi.org/10.11005/jbm.2017.24.2.97
11. Shankar S, Hosking DJ. Biochemical assessment of Paget’s disease of bone. J Bone Miner Res 2006;21(Suppl
2):22-27. https://doi.org/10.1359/jbmr.06s204
12. Theodorou DJ, Theodorou SJ, Kakitsubata Y. Imaging of Paget disease of bone and its complications: review. AJR Am J Roentgenol 2011;196(6Suppl):S64-S75. https://doi.org/10.2214/AJR.10.7222
13. Khurjekar KS, Vidyadhara S, Dheenadhayalan J, Rajasekaran S. Spontaneous rapid osteolysis in Paget’s disease after internal fixation of subtrochanteric femoral fracture. Singapore Med J 2006;47(10):897-900. PMID: 16990967
14. Shardow DL, Giannoudis PV, Matthews SJ, Smith RM. Stabilisation of acute femoral fractures in Paget’s disease. Int Orthop 1999;23(5):283-5. https://doi.org/10.1007/s002640050372
15. McDonald DJ, Sim FH. Total hip arthroplasty in Paget’s disease a follow-up note. J Bone Joint Surg Am
1987;69(5):766-72. PMID: 3597478
16. Imbuldeniya A, Tai S, Aboelmagd T, Walter WL, Wlater WK, Zicat BA. Cementless hip arthroplasty in Paget’s
Disease at long-term follow-up (average of 12,3 years). J Arthroplasty 2014;29(5):1063-6.
https://doi.org/10.1016/j.arth.2013.10.015
17. Amundsen S, Koenig K, Goodwin D, Memoli V. Failure of primary total hip arthroplasty secondary to new onset of Paget disease. A case report. JBJS Case Connect 2015;5(1):e19-e5. https://doi.org/10.2106/JBJS.CC.M.00096
18. Werner de Castro GR, Fernandes de Castro SA, Pereira IA, Zimmermann AF, Toscano MA, Souza Neves F, et al.
Determinants of quality of life in Paget’s Disease of bone. Rev Bras Reumatol (Engl Ed) 2017;57(6):566-73.
https://doi.org/10.1016/j.rbre.2017.06.002
19. Lozano-Calderon SA, Colman MW, Raskin KA, Hornicek FJ, Gebhardt M. Use of bisphosphonates in orthopedic
surgery. Pearls and pitfalls. Orthop Clin North Am 2014;45(3):403-16. https://doi.org/10.1016/j.ocl.2014.03.006
https://doi.org/10.1016/j.amjmed.2018.04.028
2. Crego-Vita D, Aedo-Martin D, Sánchez-Pérez C. Case report of early aseptic loosening of total hip arthroplasty
inmonostotic paget disease, a diagnostic challenge. Int J Surg Case Rep 2016;24:215-8.
https://doi.org/10.1016/j.ijscr.2016.05.050
3. Siris E, Ottman R, Flaster E, Kelsey JL. Familial aggregation of Paget’s disease of bone. J Bone Miner Res
1991;6(5):495-500. https://doi.org/10.1016/j.ijscr.2016.05.050
4. Ralston SH, Layfield R. Pathogenesis of Paget’s disease of bone. Calcif Tissue Int 2012;91(2):97-113.
https://doi.org/10.1007/s00223-012-9599-0
5. Reddy SV. Etiology of Paget’s disease and osteoclast abnormalities. J Cell Biochem 2004;93(4):688-96.
https://doi.org/10.1002/jcb.20256
6. Vallet M, Ralston SH. Biology and treatment of Paget’s disease of bone. J Cell Biochem 2016;117(2):289-99.
https://doi.org/10.1002/jcb.25291
7. Schneider D, Hofmann MT, Peterson JA. Diagnosis and treatment of Paget’s disease of bone. Am Fam Physician 2002;65(10):2069-72. PMID: 12046775.
8. Wegrzyn J, Pibarot V, Chapurlat R, Carret JP, Béjui-Hugues J, Guyen O. Cementless total hip arthroplasty in Paget’s disease of bone: a retrospective review. Int Orthop 2010;34(8):1103-9. https://doi.org/10.1007/s00264-009-0853-7
9. Siris E, Roodman GD. Paget’s disease of bone. En: Rosen CJ, Compston JE, Lian JB (eds). ASBMR Primer on
the metabolic bone diseases and disorders of mineral metabolism 7th ed. American Society for Bone and Mineral Research, New Jersey: Wiley; 2008: 335-43.
10. Kang H, Park YC, Yang KH. Paget’s disease: skeletal manifestations and effect of bisphosphonates. J Bone Metab. 2017;24(2):97-103. https://doi.org/10.11005/jbm.2017.24.2.97
11. Shankar S, Hosking DJ. Biochemical assessment of Paget’s disease of bone. J Bone Miner Res 2006;21(Suppl
2):22-27. https://doi.org/10.1359/jbmr.06s204
12. Theodorou DJ, Theodorou SJ, Kakitsubata Y. Imaging of Paget disease of bone and its complications: review. AJR Am J Roentgenol 2011;196(6Suppl):S64-S75. https://doi.org/10.2214/AJR.10.7222
13. Khurjekar KS, Vidyadhara S, Dheenadhayalan J, Rajasekaran S. Spontaneous rapid osteolysis in Paget’s disease after internal fixation of subtrochanteric femoral fracture. Singapore Med J 2006;47(10):897-900. PMID: 16990967
14. Shardow DL, Giannoudis PV, Matthews SJ, Smith RM. Stabilisation of acute femoral fractures in Paget’s disease. Int Orthop 1999;23(5):283-5. https://doi.org/10.1007/s002640050372
15. McDonald DJ, Sim FH. Total hip arthroplasty in Paget’s disease a follow-up note. J Bone Joint Surg Am
1987;69(5):766-72. PMID: 3597478
16. Imbuldeniya A, Tai S, Aboelmagd T, Walter WL, Wlater WK, Zicat BA. Cementless hip arthroplasty in Paget’s
Disease at long-term follow-up (average of 12,3 years). J Arthroplasty 2014;29(5):1063-6.
https://doi.org/10.1016/j.arth.2013.10.015
17. Amundsen S, Koenig K, Goodwin D, Memoli V. Failure of primary total hip arthroplasty secondary to new onset of Paget disease. A case report. JBJS Case Connect 2015;5(1):e19-e5. https://doi.org/10.2106/JBJS.CC.M.00096
18. Werner de Castro GR, Fernandes de Castro SA, Pereira IA, Zimmermann AF, Toscano MA, Souza Neves F, et al.
Determinants of quality of life in Paget’s Disease of bone. Rev Bras Reumatol (Engl Ed) 2017;57(6):566-73.
https://doi.org/10.1016/j.rbre.2017.06.002
19. Lozano-Calderon SA, Colman MW, Raskin KA, Hornicek FJ, Gebhardt M. Use of bisphosphonates in orthopedic
surgery. Pearls and pitfalls. Orthop Clin North Am 2014;45(3):403-16. https://doi.org/10.1016/j.ocl.2014.03.006